mcq psychiatry

8/10/2019 MCQ Psychiatry

1/14

Psychiatry 1 MCQs

1 With personality disorders, the following are true EXCEPT

A Cluster C represents the anxious & fearful group of personality disorders

B Personality disorder is a Axis III diagnosis

C Both Anti-social and Histrionic personality disorders are found in Cluster B

D A person with Avoidant personality disorder is socially withdrawn but actuallywould like to have friends

Answer

2 Organic causes for mental disorder are more likely in all the following

EXCEPT those with

A Visual hallucinations

B A family history of psychiatric illness

C Onset in the last 2 days

D Age >30 years

Answer

3 The following is FALSE with regards to the Mini-Mental State Examination:

A Has a sensitivity of 87% for presence of delirium

B Has a specificity of 82% for presence of delirium

C A score less than 20 suggests organic brain aetiology

D Is used to differentiate delirium from dementia

Answer

4 With regards to drugs used for chemical restraint , which is FALSE?

A Midazolam has a half-life of 2 hours

B Diazepam has a half-life of 43 hours

C Droperidol has no anti-psychotic properties

D Extrapyramidal side-effects are commoner with droperidol than haloperidol.

Answer


2/14

5 Which of the following is NOT an axis 1 diagnosis

A Munchausens

B Dementia

C Anorexia nervosa

D Intellectual retardation

Answer

6 Which of the following is an easily reversible cause of dementia?

A Myxoedema

B Alzheimers

C Korsakoffs

D Huntingtons

Answer

7 Which statement is FALSE regarding the following Anti-depressants

A Tricyclics inhibit the pump mechanism responsible for the reuptake ofSerotonin and Noradrenaline into neurons.

B Mirtazapine causes release of Serotonin and Noradrenaline and at the sametime and the same time acts as a potent 5-HT2 and 5-HT3 antagonist

C Venlafaxine causes release of Serotonin and Noradrenaline

D Moclobemide is a reversible monoamine oxidase inhibitor

Answer

8 With regard to psychiatric illness

A Schizophreniform disorder is a brief psychotic episode that lasts < 1 month

B The gender ratio of death by suicide in Australasia is 10 males to 1 female

C A patient that requires a police escort for a psychiatric presentation isAustralasian Triage Scale Category 2

D Personality disorders are considered in Axis I of the DSM-IV classificationsystem

Answer


3/14

9 Which is associated with a relatively lower suicide completion risk?

A Elderly male

B Schizophrenia

C Amphetamine abuse

D Personality disorder

Answer

10 A young man, smelling of alcohol, is brought into your ED by Police who areconcerned. He is aggressive and demanding to be discharged. How do youbest proceed next?

A Discharge home

B Admit under Duty of Care

C Admit under Form I of the Mental Health Act

D Admit under Form III of the Mental Health Act

Answer

11 Which of the following suggest a low risk for suicide at the time of interview?

A Helplessness

B Refusal to provide additional information

C Remorse regarding suicide attempt

D Exhaustion

Answer


4/14

12 Which is FALSE?

A Nonauditory hallucinations suggest an organic cause

B A psychotic disorder precipitated by an extremely traumatic life experience,lasting less than 4 weeks is characteristic of a Schizophreniform disorder

C Dissociative Disorders include episodes of amnesia that are rarelypermanent

D Motor seizures secondary to alcohol withdrawal typically occur 24-48 hoursafter cessation of intake

Answer

13 A 20yo female patient arrives having cut her arms and taken an unknownquantity of an antidepressant she cannot remember the name of. Which ofthe following is NOT a correct issue of concern in her management?

A A history of multiple previous minor DSH makes her high risk for suicide.

B Co-ingestion of alcohol increases her likelihood of suicide.

C A subsequent convulsion does not clarify the mot likely antidepressanttaken.

D A co-ingestion of benzodiazepine is likely to worsen her outcome.

Answer

14 A 12 year-old girl is brought in by her mother as she has recurrent severeabdominal pain which the GP has not been able to identify despite repeatedreviews, bloods and an USS. She is trendily dressed with plenty of make-up.It is important that you!.

A Concentrate on her abdominal symptoms and signs as the GP is clearlyincapable of basic medical management.

B Include an assessment of her fingertips, teeth, gag reflex and hair.

C Talk to the patient with her mother present to ensure she gives you anaccurate history.

D Concentrate on her previous history of DSH, depression and alcoholingestion.

Answer


5/14

15 Which of the following is TRUE regarding Bipolar affective disorder?

A Rapid Cyclers have 5 or more episodes of mania and depression per year.

B Male : Female incidence is equal

C Criteria include poor self esteem and flight of ideas

D Most patients with a manic state do not have Bipolar affective disorder

Answer

16The leading cause of death in Australia in the under 30s is

A Trauma

B Cancer

C Suicide

D Congenital disease

Answer

17 Patients with schizophrenia typically complain of:

A Formication

B Visual hallucinations

C Pressure of speech

D Voices arguing about them

Answer

18Which feature is MOST consistent with an acute psychotic illness?

A Focal neurological signs

B Disordered speech or behaviour

C Impaired cognition

D Fluctuating mental state

Answer


6/14

19In regard to Phobias & Panic disorders, which statement is FALSE?

A Patients suffering social or specific phobias may experience situationalbound or situational predisposed panic attacks.

B Patients suffering from panic disorder or depression may have panic attackswithout any trigger needed.

C With phobia, the patient is unable to recognise that the fear is excessive.

D Symptoms typical of panic attack may occur in association with numerousmedical conditions.

Answer

20

All of the following have been associated with neuroleptic malignantsyndrome EXCEPT :

A Nortriptyline

B Olanzipine

C Organic brain disease

D Haloperidol

Answer

21With regard to extrapyramidal movement disorders

A They may be reversible on ceasing antipsychotics

B They are experienced in up to 90% of patients taking typical anti-psychotics

C Dystonic reactions more commonly affects muscles of the back and arms

D Parkinsonism occurs late (after years) in the treatment with anti-psychotics

Answer


7/14

22 Which statement regarding Lorazepam is FALSE?

A Lorazepam may be given undiluted by Intra-Muscular injection for StatusEpilepticus

B Lorazepam requires dilution with equal volume of a compatible fluid e.g. 5%Dextrose before using Intra-Venously

C Flumazenil is the anti-dote to use in the patient with suspected Lorazepamoverdose

D Lorazepam may be used for short term treatment of Anxiety and Insomnia

Answer

23 Which statement regarding Doxepin overdose is FALSE?

A Its anti-histamine effects are more marked than most other TCA drugs.

B TCAs do not antagonise Acetyl-choline at the Nicotinic receptors

C Doxepin causes seizures through its antagonism of GABA receptors andSodium channel blockade

D Neurotoxicity with subsequent seizure is the most important factor causingmortality

Answer

24 A 48yo woman has ingested an unknown amount of Lithium carbonate 2hours ago. This had been started 3 weeks ago by her psychiatrist. Which ofthe following is TRUE?

A A lithium level should be taken at 4 hours post ingestion

B The first signs of toxicity are usually gastrointestinal symptoms

C The most common ECG abnormality is QRS prolongation

D Ataxia is a late sign of significant toxicity

Answer


8/14

25 A patient who is on an MAO-I antidepressant, Moclobemide, presents with afever, hypertension and rigidity. Which of the following would be the leastlikely to be a precipitant of this presentation?

A Pethidine

B Citalopram

C Well ripened cheese ingestion 3 days earlier

D Cold and flu tablets containing Pseudoephedrine

Answer

26 Which of the following is TRUE regarding atypical antipsychotics?

A Olanzapine has a good safety profile in diabetics

B Risperidone is particularly safe in the elderly demented patient

C Risperidone is more rapidly bioavailable than Olanzapine orally

D Olanzapine and Risperidone exert their actions by acting on 5HT1 and D1receptors

Answer

27 Olanzapine acts at which of the following receptors?

A 5HT2

B D2

C M1

D All of above

Answer

28 Atypical antipsychotics are associated with increased mortality in?

A Elderly patients

B Type 2 Diabetics

C Patients with heart disease

D All of the above

Answer


9/14

29 Which would NOT be expected in 3g Venlafaxine overdose in adult?

A Torsades de pointes

B Serotonin syndrome

C Asymptomatic

D Seizures

Answer

30 Which of the following is NOT a side effect of Sertraline use?

A Hyponatraemia

B Decreased libido

C Weight gain

D Constipation

Answer

31 Risk factors for increased toxicity of lithium include all the followingEXCEPT!.

A Dehydration from any cause

B diuretics

C Theophylline

D Low sodium

Answer

32 Which of the following is found in anorexia nervosa?

A Lower mortality in bulimics compared with pure anorexics.

B hyperkalaemia

C Decreased aldosterone

D Prolonged QT, SVT and dysrhythmias

Answer


10/14

33 Which of the following is FALSE with regards to Schizophrenia?

A It is characterized by loosening of associations, auditory hallucinations anddelusions

B It has a 10-15% lifetime suicide risk

C Relapse is commonly associated with non-compliance with medications

D Hallucinations are required to make a diagnosis

Answer

34 Which of the following statements is FALSE?

A In Panic Disorders, anxiety and fear are more common presentations to EDthan palpitations, sweating, SOB and dizziness

B An example of a Phobic Disorder is Anataediphobia

C In General Anxiety Disorders, fear exceeds that of the expected threat

D Obsessive Compulsive Disorder is characterized by unpleasant intrusivethoughts

Answer

35 Which of the following is NOT a feature of Delirium?

A Visual hallucinations

B Tactile hallucinations

C Auditory hallucinations

D Determination of a pathogenic cause is required

Answer

36 Side effects of Lithium use include

A Fine tremor

B Coarse tremor

C Weight loss

D Thirst

Answer


11/14

37 Regarding conversion disorders which is FALSE

A They are defined as a loss or change of function suggesting a physicaldisorder but caused by a psychological conflict

B 90% of the time present as neurological symptoms/disorders

C Often the patient seems relatively unconcerned about the symptom

D The symptom production is a conscious one

Answer

38 Which of the following is INCORRECT regarding panic attacks

A May present with carpopedal spasm

B Hyperventilation can cause T wave changes on ECG

C SpO2 will be normal to make this diagnosis

D There is no associated suicide risk with recurrent episodes

Answer

39 Medications that are known to be significantly associated with depressioninclude all of the following EXCEPT:

A phenytoin

B oral contraceptives

C digoxin

D isotretinoin

Answer

40 Medical conditions that are associated with depression include all of thefollowing EXCEPT:

A hypocalcaemia

B lung carcinoma

C stroke

D pancreas carcinoma

Answer


12/14

41 Which of the following is uncommon in delirium

A Illusions or misinterpretations

B Structured delusions

C A fluctuating course

D Abrupt onset

Answer

42 Which antidepressant class is INCORRECT

A Citalopram serotonin and noradrenaline reuptake inhibitor

B Mirtazapine noradrenaline and selective serotonin antagonist

C Sertraline selective serotonin reuptake inhibitor

D Moclobemide reversible monoamine oxidase inhibitor

Answer

43 Schizophrenia!

A Has a 20yr suicide rate of up to 22%

B Is typically associated with olfactory hallucinations

C Is more common in males

D Has a prevalence of 1-2% of the population

Answer

44 Which of the following is a NOT a high risk factor for suicide in Australia?

A Personality disorder

B Schizophrenia

C Female sex

D Aboriginal

Answer


13/14

45 Which of these patients would MOST appropriately be assigned an ATS2triage category?

A An aggressive patient wielding a knife.

B A cooperative patient requesting treatment for depression.

C A tearful and anxious patient who keeps returning to the triage desk to askhow long the wait to be seen is.

D An agitated patient who says he can see demons in the walls.

Answer

46 Which is TRUE regarding suicide:

A Suicide is the second leading cause of death in Australia for those aged


14/14

Answers

1. B2. D3. D

4. D5. D6. A7. C8. C9. D10. B11. C12. B13. D14. B15. B16. C

17. D18. B19. C20. A21. B22. C23. D24. B25. C26. C27. D28. D29. A

30. C31. C (theo increases clearance of lithium. causes cardiac abnormalities = Ebsteins32. D33. D No hallucinations in Catatonic (waxy flexibility, mute, rigidity and hypertonic) and

Disorganized schizophrenia34. A35. D36. C37. D Dunn38. D Dunn39. A Textbook of Adult Emergency Medicine (Cameron et al.), 3

rded., p.637

40. A Textbook of Adult Emergency Medicine (Cameron et al.), 3rd

ed., p.63741. B Cameron, page 623

42. A Trevors notes43. A B auditory hallucinations, C male:female 1:1, D prevalence 0.2-0.5%

Cameron Ch 20.544. C males higher risk for successful suicide (except China) Cameron Chapter 20.345. D Dunn p833 (A: ATS1, B: ATS4or5, C: ATS3or4, D: ATS 2 due to hallucinations)46. B Dunn p843 (leading cause, men are more successful but women are more likely to

attempt, pts commonly seek help prior to suicide)47. A Cameron (3

rded) p 625-627. A: Hanging and DSP 40% each of female suicides (total

80%), 50 and 30% respectively for males (80%) B: Males >80yrs greatest agespecific risk. Though also peak 30-34 years C: Mood disorders (esp majordepression) greatest suicide risk D: 10% suicides seen in ED

mcq psychiatry

Documents